Toward a Standardized and Individualized Laboratory-Based Protocol for Wheelchair-Specific Exercise Capacity Testing in Wheelchair Athletes

Abstract

Previous studies on handrim wheelchair-specific (an)aerobic exercise capacity in wheelchair athletes have used a diversity of participants, equipment, and protocols. Therefore, test results are difficult to compare among studies. The first aim of this scoping review is to provide an overview of the populations studied, the equipment and protocols used, and the reported outcomes from all laboratorybased studies on wheelchair-specific exercise capacity in wheelchair athletes. The second aim is to synthesize these findings into a standardized, yet individualized protocol. A scoping literature search resulted in 10 anaerobic and 38 aerobic protocols. A large variety in equipment, protocol design, and reported outcomes was found. Studies that systematically investigated the influence of protocol features are lacking, which makes it difficult to interpret and compare test outcomes among the heterogeneous group of wheelchair athletes. Protocol design was often dependent on a priori participant knowledge. However, specific guidelines for individualization were missing. However, the common protocol features of the different studies were united into guidelines that could be followed when performing standardized and individualized wheelchair-specific exercise capacity tests in wheelchair athletes. Together with guidelines regarding reporting of participant characteristics, used equipment, and outcome measures, we hope to work toward more international agreement in future testing.

Evaluation of a standardized test protocol to measure wheelchair-specific anaerobic and aerobic exercise capacity in healthy novices on an instrumented roller ergometer

“…The effects of sport discipline, training and disability explain the wide range of test results found among wheelchair athletes, but variation and study differences are also amplified by the use of different methods (e.g. testing device, wheelchair geometry, test protocol) [ 9 ]. Nevertheless, the three main outcomes (F iso , P30, POpeak) of the current study all seem to fall within the range of results obtained by wheelchair athletes, which seems to enhance the potential of this test protocol studied in wheelchair athletes.…”

“…Implementing the methods explored in this study can have a positive impact on future wheelchair-specific exercise capacity testing. Literature evidences a large variation in WAnT and GXT test protocols [ 9 ]; the currently studied standardized and individualized resistance settings can produce more uniform protocols and settings. This is especially needed in the diverse athletic and/or patient populations, and will enhance comparisons between different studies as well as among athletes or patients over time [ 9 ].…”

“…A recent literature review of studies examining WAnTs and GXTs in wheelchair athletes [ 9 ] showed that resistance settings differed among the studies and were often based on the expertise of the test leader and/or a priori knowledge on the evaluated athletes. These protocol settings are difficult to reproduce, hampering comparison among studies.…”

Role of technology in athlete assessment

“…Left: To impose the desired power output a pulley-system is attached to the wheelchair on the treadmill. Right: A drag test is performed to determine power output of the user-wheelchair combination FIGURE 11.5 Illustration of the power output signal from the wheelchair ergometer and definition of some wheelchair propulsion outcomes: push time (from push start to push end), cycle time (from push start to push start), and power loss before (PnegS) and after (PnegE) the push time force and (an)aerobic exercise capacity and thus can be applied for profiling and systematically monitoring the effect of training or changes to the assistive device (Janssen et al, 2021). Furthermore, the wheelchair ergometer can be used during training and direct visual feedback of propulsion technique variables, such as peak force and push time, can be provided to the athlete and coach on a monitor during propulsion to improve specific aspects of wheelchair propulsion (Richter et al, 2011).…”

Wheeling performance in wheelchair tennis

“…In the lab, a standardised experiment, regarding resistance and velocity can be conducted on a treadmill or a wheelchair ergometer, preferably with individualised standardised protocols (34,35). A new roller ergometer can even measure players in their own tennis wheelchair during (sub)maximal and sprint tests, with sprinting not being possible on a regular treadmill (36).…”